Surgical Treatment of Prosthetic Valve Endocarditis after Reconstruction of the Intervalvular Fibrous Trigon -A case report-

판막간 섬유체 재건을 시행한 후 발생한 인공판막 심내막염의 수술적 치유 -1예 보고-

  • Choi, Seon-Uoo (Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Wook-Sung (Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Min, Ho-Ki (Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kang, Min-Woong (Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lee, Young-Tak (Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Park, Pyo-Won (Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • 최선우 (성균관대학교 의과대학 삼성서울병원 흉부외과학교실) ;
  • 김욱성 (성균관대학교 의과대학 삼성서울병원 흉부외과학교실) ;
  • 민호기 (성균관대학교 의과대학 삼성서울병원 흉부외과학교실) ;
  • 강민웅 (성균관대학교 의과대학 삼성서울병원 흉부외과학교실) ;
  • 이영탁 (성균관대학교 의과대학 삼성서울병원 흉부외과학교실) ;
  • 박표원 (성균관대학교 의과대학 삼성서울병원 흉부외과학교실)
  • Published : 2008.12.05

Abstract

We report here on a case of performing a redo-operation for a 65-years-old male patient who had prosthetic endocarditis after reconstruction of the fibrous skeleton due to infective endocarditis 8 years earlier. An aortic annular abscess with a 1cm sized subvalvular abscess and mobile mitral valve vegetation with destruction of the fibrous skeleton was shown on the preoperative echocardiography. An emergency operation was performed due to heart failure. Reconstruction of both the aortic and mitral annuli and the fibrous skeleton was done by using two separate bovine pericardial patches and then mechanical valves were implanted. The postoperative echocardiography shows no paravalvular leakage. The patient has been followed up with no symptoms.

저자들은 8년 전 감염성 심내막염으로 대동맥판막과 승모판 치환 및 섬유체 재건을 시행한 65세 남자 환자에서 발생한 인공판막 심내막염에 대하여 재수술을 시행한 예를 보고한다. 환자는 술 전 심초음파 소견상 1cm크기의 판막하 농양을 동반한 대동맥 판막륜 농양과 승모판 Vegetation 및 섬유체 결손을 보였다. 심부전 소견이 심하여 응급수술을 시행하였다. 두개의 소 심낭 패취를 이용하여 절재된 대동맥판과 승모판의 판륜 및 섬유체를 재건한 다음 기계판막을 대치하였다. 술 후 심초음파 소견상 판막주위 누출은 없었다. 현재 특별한 합병증 없이 통원 치료 중이다.

Keywords

References

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